Director of Compliance & Risk Management

Job Description

Job Description

POSITION SUMMARY:

The Director of Compliance and Risk Management is responsible for overseeing and managing the organization's compliance and risk management program, ensuring adherence to regulatory requirements and internal policies. This role plays a critical part in maintaining organizational integrity by implementing compliance strategies, risk management processes, and contract oversight. The Director of Compliance and Risk Management collaborates closely with the senior leadership team to develop, implement, and monitor compliance initiatives, ensuring the organization meets the Seven Elements of an Effective Compliance Program.

ESSENTIAL DUTIES & RESPONSIBILITIES:

• Lead and chair the Compliance Committee, ensuring effective oversight and implementation of compliance policies.
• Develop and maintain a comprehensive FQHC Compliance Program in alignment with Section 330 of the Public Health Services Act and HRSA’s Health Center Program Compliance Manual.
• Oversee and manage contract compliance, risk management, and adherence to federal, state, and local regulatory requirements, including but not limited to HIPAA, 340B, HRSA and OSHA.
• Establish, maintain, and update essential compliance policies, including but not limited to HIPAA, Safety, 340B, Risk Management, and Emergency Preparedness.
• Design and implement an annual audit plan targeting high-risk areas such as billing, coding, documentation, HIPAA, investigations, cybersecurity, fraud prevention, grants management, and revenue protection.
• Conduct annual HIPAA risk assessments, ensuring compliance with Security Rule administrative, physical, and technical safeguards.
• Develop and enforce employee compliance training programs, ensuring all staff members receive legally mandated and policy-required training.
• Oversee the monitoring and tracking of critical compliance requirements including employee attestations, performance evaluations, incident reporting, onboarding, CME and tuition reimbursement requests, and other policy requirements.
• Investigate and document incidents, escalating significant matters to the Chief Executive Officer as needed.
• Ensure effective compliance assessments of employees, clinical staff, and contractors by regularly reviewing the National Practitioner Data Bank, state licensure records, HHS-OIG’s List of Excluded Individuals/Entities, and GSA’s debarred parties list.
• Maintain compliance with accreditation and regulatory standards by assessing staff competencies and addressing any compliance deficiencies.
• Manage the organization’s risk management program, proactively identifying and mitigating legal risks.
• Collaborate with external auditors and regulatory bodies for audits or to address compliance-related matters.
• Effectively fulfill responsibilities of the organization’s Safety Officer, ensuring safety protocols, drills, and emergency preparedness plans are up to date and effectively implemented.

• Maintain compliance related to organizational policies, including updates to the Employee Handbook in collaboration with senior leadership team.
• Coordinates and manages legal advice and expenses of external counsel for the organization.
• Appropriately delegate contracts to internal or external subject matter experts when appropriate. Assist with negotiating with vendors to ensure favorable contracts for Long Island Select Healthcare.
• Ensure finance approves each contract, when necessary, and signatories review, approve, and sign all contracts.
• Ensure proper documentation, approval, and storage of contracts.
• Partner with Finance to ensure compliance in benefits selection and administration, FMLA, disability claims, COBRA, and workers’ compensation.
• Review job descriptions to ensure compliance with regulatory requirements
• Regularly review and update the Compliance Manual, Annual Compliance Plan, and Annual Compliance Report in alignment with evolving regulatory requirements.
• Develop system of reporting compliance policy changes to the CEO

QUALIFICATIONS & COMPETENCIES:

• Education & Certification: Bachelor’s degree required. Healthcare compliance certification preferred.
• Experience: Minimum of 5 years in healthcare compliance. Experience in community-based healthcare setting preferred.
• Technical Proficiency: Strong knowledge of regulatory compliance, operationalizing compliance programs, and Microsoft Office applications.
• Communication & Leadership: Exceptional written and verbal communication skills.
• Problem-Solving & Initiative: Ability to work independently, manage multiple priorities, and execute projects efficiently in a fast-paced environment.
• Interpersonal Skills: Strong relationship-building capabilities to foster a culture of compliance and ethical practice within the organization.
• Transportation: Must have reliable transportation and a valid New York driver’s license.

This position is a critical component in safeguarding the integrity, efficiency, and compliance of the organization. The Director of Compliance and Risk Management must demonstrate expertise, discretion, and leadership to ensure ongoing regulatory adherence and organizational success.